STUDIES ON MALARIAL PARASITES : VII. METHODS AND TECHNIQUES FOR CULTIVATION

Cultivation of Asexual Intraerythrocytic Stages of Plasmodium falciparum

Successfully developed in 1976, the continuous in vitro culture of Plasmodium falciparum has many applications in the field of malaria research. It has become an important experimental model that directly uses a human pathogen responsible for a high prevalence of morbidity and mortality in many parts of the world and is a major source of biological material for immunological, biochemical, molecular, and pharmacological studies. Until present, the basic techniques described by Trager and Jensen and Haynes et al. remain unchanged in many malaria research laboratories. Nonetheless, different factors, including culture media, buffers, serum substitutes and supplements, sources of erythrocytes, and conditions of incubation (especially oxygen concentration), have been modified by different investigators to adapt the original technique in their laboratories or enhance the in vitro growth of the parasites. The possible effects and benefits of these modifications for the continuous cultivation of asexual intraerythrocytic stages of P. falciparum, as well as future challenges in developing a serum-free cultivation system and axenic cultures, are discussed.

The role of Plasmodium knowlesi in the history of malaria research

In recent years, a malaria infection of humans in South East Asia, originally diagnosed as a known human-infecting species, Plasmodium malariae, has been identified as a simian parasite, Plasmodium knowlesi. This species had been subject to considerable investigation in monkeys since the 1930s. With the development of continuous culture of the erythrocytic stages of the human malarial parasite, Plasmodium falciparum in 1976, the emphasis in research shifted away from knowlesi. However, its importance as a human pathogen has provoked a renewed interest in P. knowlesi, not least because it too can be maintained in continuous culture and thus provides an experimental model. In fact, this parasite species has a long history in malaria research, and the purpose of this chapter is to outline approximately the first 50 years of this history.

Cultivation of parasites

Parasite cultivation techniques constitute a substantial segment of present-day study of parasites, especially of protozoa. Success in establishing in vitro and in vivo culture of parasites not only allows their physiology, behavior and metabolism to be studied dynamically, but also allows the nature of the antigenic molecules in the excretory and secretory products to be vigorously pursued and analyzed. The complex life-cycles of various parasites having different stages and host species requirements, particularly in the case of parasitic helminths, often make parasite cultivation an uphill assignment. Culturing of parasites depends on the combined expertise of all types of microbiological cultures. Different parasites require different cultivation conditions such as nutrients, temperature and even incubation conditions. Cultivation is an important method for diagnosis of many clinically important parasites, for example, Entamoeba histolytica, Trichomonas vaginalis, Leishmania spp., Strongyloides stercoralis and free-living amoebae. Many commercial systems like InPouch TV for T. vaginalis, microaerophilous stationary phase culture for Babesia bovis and Harada-Mori culture technique for larval-stage nematodes have been developed for the rapid diagnosis of the parasitic infections. Cultivation also has immense utility in the production of vaccines, testing vaccine efficacy, and antigen - production for obtaining serological reagents, detection of drug-resistance, screening of potential therapeutic agents and conducting epidemiological studies. Though in vitro cultivation techniques are used more often compared with in vivo techniques, the in vivo techniques are sometimes used for diagnosing some parasitic infections such as trypanosomiasis and toxoplasmosis. Parasite cultivation continues to be a challenging diagnostic option. This review provides an overview of intricacies of parasitic culture and update on popular methods used for cultivating parasites.

STUDIES ON MALARIAL PARASITES : VI. THE CHEMISTRY AND METABOLISM OF NORMAL AND PARASITIZED (P. KNOWLESI) MONKEY BLOOD

1. Normal monkey, Macaca mulatta, plasma and red cells are similar in their inorganic composition to those of human beings. Inorganic phosphate values of plasma and red cells from parasitized monkey blood are lower than normal. Plasma potassium values are higher than normal particularly during segmentation. Other inorganic components of parasitized blood show little variation from normal. 2. Monkey red blood cells parasitized with P. knowlesi consume oxygen in the presence of glucose, lactate, glycerol, and amino acids as substrates. Their respiration is inhibited by cyanide, carbon monoxide, and high oxygen tensions. Normal monkey red blood cells consume oxygen at an appreciable rate only in the presence of methylene blue. 3. Parasitized erythrocytes convert glucose to lactate at a rate 25 to 75 times that of the normal monkey erythrocyte. Unlike the normal red cell, the parasitized cell utilizes lactate if oxygen is present. Lactate is utilized, however, at a rate that is only one-sixth that of its production from glucose. 4. The significance of these findings in relation to the problem of cultivation of malarial parasites is discussed.

STUDIES ON MALARIAL PARASITES : VIII. FACTORS AFFECTING THE GROWTH OF PLASMODIUM KNOWLESI IN VITRO

1. Methods have been described for the preparation and sterilization of a synthetic nutrient medium which supports normal growth during one 24 hour asexual cycle of the erythrocytic form of P. knowlesi. 2. Successive subcultures with good multiplication can be carried out when whole blood or plasma is added to the medium. Data are presented from two such experiments where the sixth and seventh generations, respectively, were injected into normal monkeys. In both cases, the injections produced clinical malaria and in one, an abnormally severe course was observed. 3. A high percentage (95 per cent) of O(2) inhibits multiplication in in vitro cultures. A gas phase approximating alveolar air permits normal development. A lower percentage (0.37 per cent) of O(2) in the gas phase supports growth at least as well. 4. Certain experiments indicate that in vitro growth is better supported in normal monkey plasma than in plasma from parasitized monkeys. Heating of parasitized plasma to 56 degrees C. for 30 minutes removed the deleterious effect. 5. A nutritional need by the parasite for glucose and p-aminobenzoic acid has been shown. Attempts to demonstrate the need for other individual components of the nutrient medium have not been successful though the effect of the absence of blocks of nutrient such as purines and pyrimidines, amino acids, or water-soluble vitamins can be observed. 6. Further assay of the nutritional requirements of the parasite appears to be hampered by the supply of nutrient furnished by the red cells and plasma. Cultivation of parasitized cells washed free of plasma and resuspended in synthetic medium containing 1 per cent serum albumin has been accomplished as one step directed toward the removal of such interfering factors.

The use of proprietary tissue-culture media for the cultivation in vitro of the erythrocytic stages of Plasmodium knowlesi

An improved perfusion apparatus for the cultivation of malaria parasites is described. It consists of a sandwich of three chambers, of which the outer two contained medium and the inner contained the infected blood sample.

Using this apparatus and rocker-dilution cultures it has been shown that medium ‘199’ and medium ‘NCTC 135’ are as good as the Harvard medium for the cultivation of P. knowlesi in vitro.

The asexual cycle of P. knowlesi took slightly longer in vitro than in vivo. The stage of development at which the parasite was inoculated into culture affected the amount of reinvasion of new host cells. Thus, a greater amount of re-invasion was obtained with an inoculum of schizonts than with one of ring stage parasites. The rate of multiplication of the parasite decreased at each successive subculture.

I should like to thank Dr F. Hawking and Dr J. Williamson for their advice, Mr T. J. Scott-Finnigan for technical assistance, Mr F. R. Wanless and Mr C. D. Sutton for taking the photographs, and Mr F. A. New for drawing the figures. The perfusion apparatus was made by Mr T. Harding of the Engineering Division, National Institute for Medical Research. This work received financial assistance from the World Health Organization.

Rate of potassium exchange of the human erythrocyte

1. The exchange of potassium by the human erythrocyte has been studied in vitro using radioactive potassium. 2. An incubation technique which maintains erythrocytes in an essentially normal state for over 48 hours was employed. 3. Exchange of radioactive potassium between the red cells and the extracellular fluid was regular and progressive, the specific activities of the intra- and extracellular fluids reaching equal values. This indicates that all the erythrocyte potassium is exchangeable and is exchanging at the same rate. 4. From these data, it was calculated that at 37 degrees C., 1.6 per cent of the erythrocyte potassium exchanges per hour, corresponding to an exchange of 1.5 mM of potassium per liter of red cells per hour. The time required for the exchange of 50 per cent of the red cell potassium is calculated to be 43 hours. 5. The temperature coefficient (Q(10)) of the potassium exchange rate is 2.2. This is the same as the temperature coefficient of the rate of utilization of glucose by the human erythrocyte. 6. Varying the percentage of red cells, plasma potassium concentration, initial glucose level, and pH between 7.0 and 7.7 had no effect on the potassium exchange rate.

Folinic acid and non-dialyzable materials in the nutrition of malaria parasites

The extracellular survival of the malaria parasite Plasmodium lophurae was favored on the 4th day of incubation in vitro by the presence in the medium of added folinic acid at a concentration of about 5 microg. per ml. The development of the human malaria parasite P. falciparum intracellularly in suspensions of human erythrocytes was better in a medium with a high than in one with a low concentration of folic acid. In the early extracellular development of P. lophurae in vitro erythrocyte extract could be partially replaced by certain yeast protein preparations and by a non-dialyzable fraction, free from hemoglobin, prepared from duck erythrocyte extract by means of starch electrophoresis.

Protein turnover in retina

Rabbit retinas were exposed in vitro to 0.5-h pulses of [3H]leucine or [14C]leucine. Some retinas were harvested promptly after labeling to measure synthesis. These were combined, in double-labeling experiments, with retinas that had been returned to unlabeled medium for a subsequent 1 h or 3.75 h to measure degradation. All of the proteins were solubilized, and separated according to size by gel electrophoresis. The gels were cut into 95 slices, and each slice was differentially counted. The amount of protein in the slice was estimated from the Coomassie blue staining, and its molecular weight from the distribution of molecular weight (MW) standards. Turnover rates of the various sizes of proteins were calculated from these data using certain well-defined assumptions. Retinal protein contained about 32 X 10(3) nmol of polypeptide per g, with a median MW of 27,000. Total synthesis was at the rate of 103 nmol/g of protein/h, with the most rapid synthesis in the 33,000--43,000 MW range, at 2 nmol/g/h for every 1000 increment in MW. Protein renewal averaged 0.52%/h, but varied directly (p < 0.0001) with MW, so that proteins of 10,000 MW were being renewed at about 0.1%/h and proteins of 140,000 MW at about 1.4%/h. Taken together, the measurements of fractional renewal and the measurements of degradation of the newly synthesized proteins demonstrated that each slice contained proteins with markedly different breakdown coefficients, and provided enough information to characterize the proteins in the slice in terms of a fast and slow subgroup. This analysis indicated that: breakdown coefficients varied much more than rates of synthesis and were therefore the prime determinant of the amount of each protein that was present; as MW increased, breakdown coefficients of the long-lived proteins increased (p < 0.0001), accounting in major part for the correlation between size and turnover; most staining bands were due to proteins with peculiarly long lifespans; the proteins with the slowest turnover of all appeared to be histones; there was an unusually rapid synthesis of a 138,000 MW polypeptide with a moderately short half-life (about 3 h).

Protein synthesis in central nervous tissue: studies on retina in vitro

Rabbit retinas were maintained in vitro in medium that resembled CSF but with leucine varied from 2 to 1000 microM. Both leucine and threonine were isotopically labelled. When leucine in the medium was 100-1000 microM, leucine was incorporated into protein at 2.03 +/- 0.04 (S.E.M.) mumol/g dry wt./h, a turnover per h of 0.55% of the leucine in retinal protein. Incorporation was constant for at least 7 h. It was reduced 34% when the other amino acids were omitted from the medium and 24% when they were increased 15 fold above physiological levels. When medium leucine was reduced to 2 microM with other amino acids constant, 14C-leucine incorporation fell 70% without significant change in 3H-threonine incorporation, indicating a fall in intracellular specific activity of leucine. The intracellular/extracellular concentration ratio of labelled leucine was 4:1 with medium leucine 23 microM. It fell markedly when medium leucine was reduced to 2 microM or increased to 1000 microM. The concentration ratio of labelled threonine was 15:1 with medium leucine at physiological levels but fell to 6:1 when medium leucine was increased to 1000 microM. Decarboxylation removed 1.5% of free intracellular leucine per min and, at physiological concentrations, was 7.7% the rate of protein incorporation. The ratio of protein synthesis/breakdown, estimated from changes in leucine and 7 other essential amino acids in the medium, was nearly unity. The potential of this preparation for study of CNS protein metabolism is discussed.

Cultivation techniques for the erythrocytic stages of malaria parasites

The study of the biochemistry, physiology, and immunology of plasmodia has been restricted by the difficulty of maintaining the parasites in isolation from the host. Some success has been achieved in cultivating them in vitro, using tissue cultures and chick embryo techniques to study exoerythrocytic states and the sporogonic cycle, but no completely successful method has been found for studying the asexual and sexual stages of plasmodia in circulating red blood cells. The relative slowness with which techniques for continuous in vitro cultivation have been developed is the result of inadequate knowledge of the biochemistry of the parasites and of the blood and its constituents. However, radioactive labelling techniques applied to P. knowlesi cultures are beginning to yield data of fundamental importance. Existing methods for the short-term in vitro cultivation of plasmodia are potentially very useful for analysing malarial antigens, for developing vaccines, and for screening and studying antimalarial drugs. Investigations of the physicochemical requirements for the in vitro preservation of red blood cells are required, and more emphasis should be given to the study of plasmodia with longer cycles. Differences between the metabolism of plasmodia in vivo and in vitro should be studied and the growth factors in normal plasma identified. Studies of the membrane of the parasites and of the red blood cells, of the immune response, and of extracellular methods for the cultivation of plasmodia should be extended.

Short-term culture of Plasmodium knowlesi

The culture method developed by Geiman and co-workers has been modified to give average multiplication rates forPlasmodium knowlesiof at least six-fold in 24 h.

Individual modifications have been assessed on the basis of parasite multiplication and [3H]leucine incorporation into parasite protein. The second cycle ofin vitrodevelopment which is particularly influenced by the conditions of culture was improved by: (i) culture of washed parasitized red cells in a medium containing dialysed homologous serum screened for its ability to support parasite growth; (ii) addition of ATP, Co-enzyme A (or pantothenate) and glutamine.

We thank Mr E. D. Dennis and Miss Susan Wanstall for technical assistance. This work was supported by grants from the Medical Research Council and the World Health Organization.

Stearic acid as plasma replacement for intracellular in vitro culture of Plasmodium knowlesi

A chloroform extract of Cohn's fraction IV-4 of human plasma successfully replaced whole fraction IV-4 for the intracellular in vitro culture of Plasmodium knowlesi. We are now able to report the successful replacement of monkey plasma by stearic acid.

Plasma replacement for in vitro culture of Plasmodium knowlesi

Of six fractions of human plasma tested, only Cohn's fraction IV-4 was effective for the replacement of whole plasma from monkey (Macaca mulatta) for the in vitro culture of Plasmodium knowlesi. The effects observed on multiplication and morphology of parasites suggest a specific role of some substance or substances in fraction IV-4.

The use of phosphorus 32 in studies on Plasmodium gallinaceum. II. Studies on conditions affecting parasite growth in intact cells and in lysates

The measurement of the degree of incorporation of P(32) into nucleic acids has been used as a quantitative means of studying parasite growth and development in vitro under various conditions. An extract of normal chicken erythrocytes was found to be of unique importance as a constituent of the medium, both for intact parasitized cells and for lysates of such cells. Heated normal chicken serum possessed some favorable effect upon intact cells. The major portion of the beneficial effect of the erythrocyte extract was found to be associated with the non-dialyzable portion, although the dialysate was shown to possess slight growth-promoting activity. Further attempts to characterize the extract in terms of its favorable effects upon parasite growth were unsuccessful. A medium and conditions were developed which permitted the growth of a limited parasite population in lysates of parasitized red cells. The most important constituents of the medium were concentrated, freshly prepared erythrocyte extract and malate. Comparative studies carried out with intact parasitized cells and with lysates showed that substances and conditions exerting quite marked effects upon the intact cell system were without effect or exerted a less marked effect upon parasite growth in lysates. The possible implications of these observations are discussed and the further exploitation of this comparative approach suggested as a means of furthering our knowledge of parasite-host cell relationships.